Hello, I am 32 year old male, VL 152,000 and Tcell at 350. I just started on twice a day Kaletra and Combivir. I usually work out very hard in the gym and enjoy having a nice lean body. I have heard many stories as of late that this combo is going to make me fat around the waste and there is nothing I can do about it. I truly believe that a person needs to feel good about how they look in order to battle anything in life. Help..I am very scared about taking these meds now. Also...My side effects are severe toilet running, very itchy skin and red, nausa, and freaking tired. I have not been in the gym since I started two weeks ago. I cant even get out of bed before 12noon..because I am so tired. Is this normal. thanks for all you do K

The first month on your regimen (Kaletra/Combivir) can be a gut-busting experience--for most-it gets better. Despite the problems with tolerability I like use of Kaletra to avoid resistance early in treatment. Once you are suppressed (HIV level < 50 copies) you might discuss with your HIV doc a simplified and more tolerable regimen. It is unusual to feel so bad that you can't get out of bed! Symptomatic management of your GI complaints can be helpful. The issue of fat distribution is long-term----so--if you switch after you are suppressed you could opt for one of the more fat-friendly regimens out there (to discuss with your HIV doc). I have numerous patients who have been on long-term Kaletra without the fat problem so it is not inevitable. KH